Arthritis Care & Research最新文献

{"title":"Use of a Molecular Signature Response Classifier to Inform Treatment Selection Improves Clinical Disease Activity Among Patients with Rheumatoid Arthritis Initiating a Biologic or Targeted Synthetic Disease-Modifying Antirheumatic Drug","authors":"Fenglong Xie PhD,&nbsp;Timothy Beukelman MD, MSCE,&nbsp;Nicholas P. McCormick BS,&nbsp;Jeffrey R. Curtis MD, MS, MPH","doi":"10.1002/acr.80010","DOIUrl":"10.1002/acr.80010","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We assessed the effectiveness of PrismRA to improve clinical outcomes among patients with rheumatoid arthritis (RA) initiating treatment with a biologic or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PrismRA incorporated 19 gene expression features and four clinical features to assess a patient's likelihood of inadequate response to tumor necrosis factor inhibitor (TNFi). PrismRA was assessed in a prospective, interventional cohort study of patients initiating treatment with a b/tsDMARD. PrismRA results were provided to treating rheumatologists and incorporated into the selection of TNFi vs non-TNFi for study treatment. External comparator patients were identified in a rheumatology provider electronic health records system and matched to PrismRA patients using propensity scores. All patients had moderate-high disease activity at baseline. The primary study outcome was achievement of minimal important difference (MID) in clinical disease activity index (CDAI) at 24 weeks. Last observation carried forward was used to impute missing data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 330 PrismRA cohort patients and 990 matched comparator patients. Key baseline patient characteristics were all well-balanced between cohorts. Study treatment selection was consistent with PrismRA results in 82% of PrismRA cohort patients. CDAI MID at 24 weeks was achieved by 63.0% of PrismRA patients and 42.4% of comparator patients (odds ratio 2.31, confidence interval 1.79–2.99).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PrismRA results informing selection of TNFi vs non-TNFi treatment was associated with better CDAI outcomes compared to matched external comparator patients. PrismRA testing helps fill the need for a precision medicine approach to more rapidly identify the most effective therapy for individual patients with RA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 9","pages":"1149-1158"},"PeriodicalIF":4.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.80010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating a Pragmatic Strength Alternative for Frailty Measurement and Assessing Its Predictive Capacity Against Established Frailty Instruments in Rheumatoid Arthritis","authors":"Kylie E. Riggles BS,&nbsp;Hannah F. Brubeck BS,&nbsp;Adrienne D. Tanus MPH,&nbsp;Courtney N. Loecker PhD, MSN, APRN-NP,&nbsp;Punyasha Roul MS,&nbsp;Bryant R. England MD, PhD,&nbsp;Elizabeth R. Wahl MD, MAS,&nbsp;James S. Andrews MD,&nbsp;Namrata Singh MD,&nbsp;Joshua F. Baker MD, MSCE,&nbsp;Patricia P. Katz PhD,&nbsp;Dolores M. Shoback MD,&nbsp;Jose M. Garcia MD, PhD,&nbsp;Ariela R. Orkaby MD, MPH,&nbsp;Katherine D. Wysham MD","doi":"10.1002/acr.80013","DOIUrl":"10.1002/acr.80013","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Frailty occurs prematurely in rheumatoid arthritis (RA) and is associated with poor health outcomes. We compared the performance of four frailty instruments, including a pragmatic alternative measure using chair sit-to-stand (STS), and evaluated their abilities to predict poor health outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Frailty was measured at baseline using four instruments: the Fried Frailty Phenotype with STS (Fried-STS), the Fried Frailty Phenotype with hand grip strength (Fried-HGS), the Veterans Affairs Frailty Index (VA-FI), and the FRAIL Scale. Outcomes collected at the one-year follow-up included category of falls (none, one, more than one), category of days hospitalized (none, one to three, more than three), and a composite outcome of fall, hospitalization, or death. Ordinal logistic or logistic regression models, adjusted for age and sex, explored the association of frailty and each outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 143 participants were included (mean ± SD age 64.5 ± 11.7 years, 73% male, and 69% White). Categorization as frail differed by instrument: Fried-STS, 17%; Fried-HGS, 15%; VA-FI, 36%; and FRAIL Scale, 20%. There was poor agreement between frailty instruments (k = 0.07–0.31) except for the Fried-STS and Fried-HGS (k = 0.62). Frailty by the Fried-STS, Fried-HGS, and FRAIL Scale was associated with falls (adjusted odds ratios [aORs] 3.83–9.54, <i>P</i> &lt; 0.05). Frailty by the VA-FI was associated with days hospitalized (aOR 5.21, <i>P</i> = 0.017). Frailty by the Fried-STS, VA-FI, and FRAIL Scale was associated with higher odds of the composite measure of incident fall, hospitalization, or death (aORs 2.93–7.25, <i>P</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Each frailty measure predicted adverse health outcomes, with phenotypic and patient-reported measures predicting falls and the deficit accumulation model predicting hospitalization days. Being frail by the Fried-HGS did not predict poor outcomes as well as the other frailty instruments, including the Fried-STS.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 9","pages":"1167-1176"},"PeriodicalIF":4.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12934237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Frailty with the Risk of Incident Cancer and Cancer-related Mortality in Veterans with Rheumatoid Arthritis.","authors":"Bhavik Bansal, Aaron Baraff, Katherine Wysham, James S Andrews, Bryant R England, Ted R Mikuls, Joshua Baker, Kaleb Michaud, Alexa Meara, Una Makris, Carolyn Presley, Ariela Orkaby, Namrata Singh","doi":"10.1002/acr.80147","DOIUrl":"https://doi.org/10.1002/acr.80147","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between frailty and cancer incidence and mortality in patients with rheumatoid arthritis (RA). The study aimed to identify how frailty influences cancer risk, and cancer-specific outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed data from the Veterans Affairs Rheumatoid Arthritis (VARA) registry (2002-2023). Frailty status was categorized at baseline using the Veterans Affairs Frailty Index (VAFI): robust (VAFI <0.10), pre-frail (VAFI 0.11-0.20), and frail (VAFI >0.20). Cancer incidence and cancer-related mortality were evaluated using competing risk models, adjusting for demographics, lifestyle factors (e.g., smoking), RA characteristics (e.g., seropositivity, Disease Activity Score-28), medication use, and comorbidities. We additionally studied domain-specific frailty exposures, and linear frailty modelling in sensitivity analyses. Results A total of 2,723 individuals met eligibility criteria (mean age: 63.8 ± 11.2 years; 87.6% male; 15.4% Black). Age-adjusted cancer incidence rates per 1,000 person-years were 12.3 (robust), 15.5 (pre-frail), and 19.9 (frail). In fully adjusted models, pre-frailty (sHR: 1.37, 95% CI: 1.02-1.84) and frailty (sHR: 1.83, 95% CI: 1.23-2.71) were significantly associated with higher cancer incidence. Cancer-related mortality rates were 7.8, 10.6, and 9.8 per 1,000 person-years, with no significant associations for overall frailty. Domain-specific and sensitivity analyses were consistent with these findings.</p><p><strong>Conclusion: </strong>Frailty was independently associated with increased cancer incidence in RA, suggesting frailty may help identify patients at higher risk for malignancy.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148824074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Dual Rheumatoid Factor and Anticitrullinated Protein Antibody Seropositive, Single Seropositive, and Seronegative Rheumatoid Arthritis on Outcomes","authors":"Rebecca T. Brooks MD,&nbsp;Sara J. Achenbach MS,&nbsp;Vanessa L. Kronzer MD, MSCI,&nbsp;Elena Myasoedova MD, PhD,&nbsp;Cynthia S. Crowson PhD,&nbsp;John M. Davis III MD, MS","doi":"10.1002/acr.80009","DOIUrl":"10.1002/acr.80009","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to investigate the association between dual seropositive, single seropositive, and seronegative rheumatoid arthritis (RA) with radiographic erosions, disease flares, and death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective, population-based study of residents in Southern Minnesota with incident RA who fulfilled criteria for RA in 2003 to 2019. Radiographic erosions and flares were evaluated within one year of incident RA. All-cause mortality was obtained from medical records and death certificates. Cox models adjusted for age, sex, smoking status, year of incident RA, and comorbidities were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 1,373 patients with RA. At RA incidence, 37% were dual seropositive, 13% seropositive for anti–cyclic citrullinated protein (anti-CCP) only, 12% seropositive for rheumatoid factor (RF) only, and 38% seronegative. The highest proportion of radiographic erosions before or within one year of RA incidence was in the dual seropositive (31%) and lowest in those seropositive for anti-CCP only (13%). Flares occurred in 69% of the dual seropositive and 51% of the seropositive for anti-CCP only within the first year of RA incidence. Those seropositive for RF only had over a two-fold increase in mortality rates compared with the seronegatives (adjusted hazard ratio [aHR] 2.18, 95% confidence interval [CI] 1.47–3.24). In contrast, the dual seropositives had only a &gt;50% increase in mortality rates (aHR 1.66, 95% CI 1.21–2.28), and those seropositive only for anti-CCP had a &gt;30% increase in mortality rates (aHR 1.32, 95% CI 0.83–2.11).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with RA seropositive for RF only have an increase in mortality rates compared with patients who are dual seronegative. RF positivity could be an indicator of inflammation that requires pharmacologic treatment to decrease mortality rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 9","pages":"1159-1166"},"PeriodicalIF":4.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mycophenolate Mofetil Treatment Reduces the Risk of Treatment Escalation Due to Vascular Complications in Limited Cutaneous Systemic Sclerosis: Emulation of a Target Trial From the Italian Rheumatology Society SPRING Registry","authors":"Enrico De Lorenzis MD, PhD,&nbsp;Gerlando Natalello MD,&nbsp;Rossella De Angelis MD,&nbsp;Lucrezia Verardi MD,&nbsp;Dilia Giuggioli MD,&nbsp;Gianluigi Bajocchi MD,&nbsp;Lorenzo Dagna MD,&nbsp;Silvia Bellando-Randone MD,&nbsp;Giovanni Zanframundo MD,&nbsp;Rosario Foti MD,&nbsp;Fabio Cacciapaglia MD,&nbsp;Giovanna Cuomo MD,&nbsp;Alarico Ariani MD,&nbsp;Edoardo Rosato MD,&nbsp;Gemma Lepri MD,&nbsp;Francesco Girelli MD,&nbsp;Valeria Riccieri MD,&nbsp;Elisabetta Zanatta MD,&nbsp;Ilaria Cavazzana MD,&nbsp;Francesca Ingegnoli MD,&nbsp;Maria De Santis MD,&nbsp;Giuseppe Murdaca MD,&nbsp;Giuseppina Abignano MD, PhD,&nbsp;Giorgio Pettiti MD,&nbsp;Alessandra Della Rossa MD,&nbsp;Maurizio Caminiti MD,&nbsp;Annamaria Iuliano MD,&nbsp;Giovanni Ciano MD,&nbsp;Lorenzo Beretta MD,&nbsp;Gianluca Bagnato MD,&nbsp;Ennio Lubrano MD,&nbsp;Maria Ilenia De Andres MD,&nbsp;Alessandro Giollo MD,&nbsp;Cosimo Bruni MD, PhD,&nbsp;Martina Orlandi MD,&nbsp;Marco Fornaro MD,&nbsp;Marta Saracco MD,&nbsp;Cecilia Agnes MD,&nbsp;Pier Giacomo Cerasuolo MD,&nbsp;Gabriella Alonzi MD,&nbsp;Edoardo Cipolletta MD, PhD,&nbsp;Federica Lumetti MD,&nbsp;Amelia Spinella MD,&nbsp;Luca Magnani MD,&nbsp;Corrado Campochiaro MD,&nbsp;Giacomo De Luca MD,&nbsp;Veronica Codullo MD,&nbsp;Elisa Visalli MD,&nbsp;Carlo Iandoli MD,&nbsp;Antonietta Gigante MD,&nbsp;Greta Pellegrino MD,&nbsp;Erika Pigatto MD,&nbsp;Maria-Grazia Lazzaroni MD,&nbsp;Franco Franceschini MD,&nbsp;Elena Generali MD,&nbsp;Gianna Mennillo MD,&nbsp;Simone Barsotti MD,&nbsp;Giuseppa Pagano Mariano MD,&nbsp;Federica Furini MD,&nbsp;Licia Vultaggio MD,&nbsp;Simone Parisi MD,&nbsp;Clara Lisa Peroni MD,&nbsp;Gerolamo Bianchi MD,&nbsp;Enrico Fusaro MD,&nbsp;Gian Domenico Sebastiani MD,&nbsp;Marcello Govoni MD,&nbsp;Salvatore D'Angelo MD,&nbsp;Franco Cozzi MD,&nbsp;Fabrizio Conti MD,&nbsp;Serena Guiducci MD,&nbsp;Andrea Doria MD,&nbsp;Carlo Salvarani MD,&nbsp;Florenzo Iannone MD,&nbsp;Maria Antonietta D'Agostino MD, PhD,&nbsp;Clodoveo Ferri MD,&nbsp;Marco Matucci Cerinic MD,&nbsp;Silvia Laura Bosello MD, PhD,&nbsp;the SPRING Italian Registry Collaborators","doi":"10.1002/acr.70039","DOIUrl":"10.1002/acr.70039","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Mycophenolate mofetil (MMF) use in limited cutaneous systemic sclerosis (lcSSc) is relatively uncommon because of the lower fibrotic burden and the predominance of vascular complications. In vitro observations and clinical data from transplanted patients suggest a protective effect of MMF on endothelial function. Our aim was to evaluate the reasons for prescribing MMF treatment in patients with lcSSc and its impact on the need for escalation of vascular complication–related treatments during follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with lcSSc enrolled in the Italian Systemic Sclerosis Progression Investigation registry were retrospectively evaluated. All patients treated with MMF were matched to patients not treated with MMF, which was based on a roll-entry time-dependent propensity score built on demographics, clinical features, and baseline treatment. The escalation of vasoactive or vasodilator treatment up to 60 months was defined as the introduction of iloprost, endothelin receptor antagonists, or phosphodiesterase-5 inhibitors on top of the ongoing treatment, because of uncontrolled or newly diagnosed vascular complications. A hazards Cox model was also adopted to quantify the association of MMF treatment with treatment escalation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1,435 patients with lcSSc were evaluated, of whom 152 were prescribed MMF (17.1% male; mean age at lcSSc onset 48.7 ± 13.9 years, 54.6% anti-Scl70 positive). The prescription of MMF was more common in men and in anti-Scl70 positive, anticentromere negative patients with interstitial lung disease, myositis, and without a history of digital ulcers. After matching 107 patients with MMF-untreated controls, the overall incidence of vasoactive/vasodilator treatment escalation events related to digital ulcers over a median follow-up of 40.5 months (interquartile range 23.3–60.0) was 0.3 per 100 patient-years in the MMF-treated group and 5.4 per 100 patient-years in the matched control group, with a significant difference in treatment escalation-free survival between the two groups (hazard ratio 0.05, 95% confidence interval 0.01–0.38; <i>P</i> value = 0.004).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with lcSSc, the introduction of MMF has reduced the need for escalation of vasoactive or vasodilator treatment, suggesting that it may also help to prevent vascular complications, which frequently affect patients with lcSSc.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 9","pages":"1130-1139"},"PeriodicalIF":4.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145853500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Onset of Fibromyalgia After Exposure to a Combat Environment: A Longitudinal Cohort Study","authors":"Jay B. Higgs MD,&nbsp;Willie J. Hale PhD,&nbsp;Casey L. Straud PsyD,&nbsp;Jim Mintz PhD,&nbsp;Stacey Young-McCaughan PhD,&nbsp;Kimberly D. Gomes MS,&nbsp;Chelsea J. Sterne PhD,&nbsp;Katrina M. Lawrence-Wolff DO,&nbsp;Alan J. Bartholomew DO,&nbsp;Kevin M. Kelly MD,&nbsp;Douglas M. Maurer DO,&nbsp;Catherine Vriend PhD,&nbsp;Brett T. Litz PhD,&nbsp;Douglas E. Williamson PhD,&nbsp;Alan L. Peterson PhD,&nbsp;for the STRONG STAR Consortium","doi":"10.1002/acr.80008","DOIUrl":"10.1002/acr.80008","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Traumatic life events are hypothesized to be triggers for the onset of fibromyalgia. Posttraumatic stress disorder (PTSD) is a common comorbidity of fibromyalgia. However, limited prospective data are available on the development of fibromyalgia after exposure to high-magnitude stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This longitudinal cohort study of US military service members (N = 1,761) assessed fibromyalgia and PTSD before and upon return from combat deployment. Fibromyalgia was assessed with the 2011 questionnaire modification of the 2010 American College of Rheumatology preliminary diagnostic criteria for fibromyalgia. The PTSD Checklist Stressor-Specific Version was used to assess symptoms of PTSD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence rates of fibromyalgia in service members at predeployment (men = 2.2%; women = 2.0%) were similar to rates in civilian populations. Following deployment, the prevalence of fibromyalgia increased significantly to 8.0% in men and 11.1% in women (<i>P</i> &lt; 0.001). The prevalence of PTSD symptoms at predeployment was 20.7% in men and 18.3% in women. The prevalence post deployment increased slightly to 22.7% in men and 25.5% in women (<i>P</i> &gt; 0.05). By odd ratios, service members with PTSD predeployment were 2.96 times more likely to develop fibromyalgia post deployment, and those with fibromyalgia predeployment were 3.12 times more likely to develop PTSD post deployment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides the largest prospective data to date to support exposure to the stress of deployment to a warzone as a significant factor related to the onset of fibromyalgia. The bidirectional comorbidity between fibromyalgia and PTSD suggests a potential link in the central nervous system and has implications for management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 9","pages":"1247-1255"},"PeriodicalIF":4.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.80008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146016968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marked Long-Term Improvement in Lung Function in Melanoma Differentiation–Associated Protein 5 Antibody–Positive Dermatomyositis Patients: Experience of a Single-Center Longitudinal Cohort in North America","authors":"Jenice X. Cheah MD,&nbsp;Sangmee S. Bae MD, MS,&nbsp;Tiffany De Leon MBA,&nbsp;Yuna Lee BS,&nbsp;Rong Guo MS,&nbsp;David Elashoff PhD,&nbsp;Jennifer Wang BS,&nbsp;Ani Shahbazian BS,&nbsp;Christina Charles-Schoeman MD, MS","doi":"10.1002/acr.80004","DOIUrl":"10.1002/acr.80004","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to describe the longitudinal disease course and pulmonary outcomes of North American patients with melanoma differentiation–associated protein 5 (MDA5) antibody–associated dermatomyositis (DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty patients with MDA5 antibody–associated DM were identified in a single-center longitudinal cohort of 352 patients with idiopathic inflammatory myopathies. Longitudinal assessments of patient clinical and laboratory disease characteristics, pulmonary function tests (PFT), and high-resolution computed tomography chest scans were conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty percent (n = 24/30) of patients with MDA5 antibody–associated DM had interstitial lung disease (ILD). The overall mortality was low (2/24 at a mean ± SD follow-up of 4.0 ± 0.8 years). At this follow-up, patients were receiving 3.1 ± 1.3 therapies, including 79% receiving intravenous Ig (IVIg), 58% receiving rituximab, 67% receiving mycophenolate, and 63% receiving glucocorticoids. In 18 of 22 surviving patients with ILD who had two-year longitudinal follow-up available at 1.8 ± 0.6 years, improvements of 16% and 17% predicted forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DL<span>co</span>) were noted. In 10 of 18 patients with additional long-term follow-up available (mean ± SD 6.8 ± 3.4 years), improvements of 24% and 20% predicted FVC and DL<span>co</span> were noted. MDA5 antibody and interleukin-15 (IL-15) levels and paraoxonase 1 (PON1) enzyme activity correlated significantly with disease activity at baseline and longitudinally.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a North American MDA5 antibody–associated DM-ILD cohort treated with aggressive combination immunomodulatory therapy including predominantly mycophenolate, IVIg, and rituximab, disease mortality was low and lung function improved markedly. IL-15, PON1, and MDA5 antibody titers warrant further investigation as disease activity biomarkers in this high-risk population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 9","pages":"1112-1122"},"PeriodicalIF":4.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conflicts of Interest Reporting in Trials and Guidelines Addressing Glucocorticoid Injections for Knee Osteoarthritis","authors":"Craig Vecchiarelli PT, DPT,&nbsp;Lee Newman PT, MPT,&nbsp;Shannon T. Boyd PT, DPT,&nbsp;Jodi L. Young PT, DPT, PhD,&nbsp;Daniel I. Rhon PT, DPT, DSc, PhD","doi":"10.1002/acr.80001","DOIUrl":"10.1002/acr.80001","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to characterize conflict of interest disclosure practices in trials and guidelines recommending glucocorticoid injections for knee osteoarthritis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Three databases (CINAHL, Ovid MEDLINE ALL, and Embase) were queried for randomized controlled trials from database inception to April 2025 that assessed glucocorticoid injection treatment effect for knee osteoarthritis. Clinical practice guidelines were retrieved from a recent systematic review. Study details, authors, affiliations, and conflict of interest disclosures were extracted. Transparency and appropriateness with addressing disclosures were assessed for every article, and disclosures were examined and compared with three national public conflict of interest disclosure databases. All conflicts were categorized and proportions calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-five trials and 14 guidelines were included. Twenty-nine percent of trials (n = 22) and 14.3% of guidelines (n = 2) had no conflict of interest statement. Ten trials (13.3%) and six guidelines (42.9%) reported a conflict of interest for at least one author. Eleven trials (14.7%) and six guidelines (42.9%) had discrepancies between disclosures in articles and reports in public databases. Forty-three trial authors (34.1%) and 19 (9.4%) guideline authors had discrepancies between disclosures in the articles and public databases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Conflict of interest reporting practices in trials and guidelines assessing effectiveness of glucocorticoid injections for knee osteoarthritis are poor, with a lack of transparency. Quality and thoroughness with reporting conflicts of interest is necessary to best understand industry influence on treatment recommendations.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 9","pages":"1201-1208"},"PeriodicalIF":4.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Sleep and Shift Work With Osteoarthritis Risk","authors":"Elizabeth L. Yanik PhD, ScM,&nbsp;Abigail Bridgeman,&nbsp;Erik D. Herzog PhD,&nbsp;Vy Pham MPH,&nbsp;Bradley A. Evanoff MD, MPH,&nbsp;Farshid Guilak PhD","doi":"10.1002/acr.70040","DOIUrl":"10.1002/acr.70040","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Daily rhythms may be critical for maintaining homeostasis of joint tissues. We aimed to investigate the relationships among circadian clock disruption, sleep, and osteoarthritis (OA) risk in humans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the UK Biobank, a prospective 500,000–person cohort, we evaluated associations among sleep duration, sleeplessness/insomnia, and shift work type with four endpoints: knee OA, hip OA, total knee arthroplasty (TKA), and total hip arthroplasty. Cox regression was used to estimate associations with OA endpoints adjusting for age, sex, education, race, Townsend Deprivation Index, manual work frequency, and frequency of occupational walking/standing. Associations with and without adjustment for body mass index were estimated, as circadian clock disruption may influence OA through effects on obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For all OA endpoints, risk was highest among those getting &lt;6 hours of nightly sleep (eg, hazard ratios [HRs] for &lt;6 vs 7 hours: 1.21–1.41), and “usually” experiencing sleeplessness/insomnia compared with “never/rarely” was associated with higher risk (HRs: 1.24–1.40). Night shift workers had 24% higher knee OA risk (HR = 1.24; 95% confidence interval [CI] = 1.12–1.38) and 28% higher TKA risk (HR = 1.28; 95% CI = 1.19–1.37) compared with nonshift workers. After controlling for body mass index, associations were attenuated, but short sleep and sleeplessness/insomnia remained associated with all endpoints, and night shift work remained associated with knee OA and TKA. Sleep associations were similar after excluding participants reporting chronic knee/hip pain at sleep assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Disruption of sleep or circadian rhythms may be modifiable risk factors for OA underlying cartilage degeneration through obesity and obesity-independent pathways. These findings point to potential ways to prevent OA.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 9","pages":"1209-1219"},"PeriodicalIF":4.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13225273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146016971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Long-Term Lower Extremity Strength Training in Adults With Knee Osteoarthritis and Varus Alignment Reduce Knee Joint Loading During Gait?","authors":"Stephen P. Messier PhD,&nbsp;Matthew N. Vigliotti MS,&nbsp;Paige E. Rice PhD,&nbsp;Brian Pietrosimone PhD,&nbsp;Shannon L. Mihalko PhD,&nbsp;Edward H. Ip PhD,&nbsp;Richard F. Loeser MD,&nbsp;David J. Hunter MBBS, PhD,&nbsp;Ali Guermazi MD, PhD,&nbsp;Ryan Hill MS,&nbsp;Santiago Saldana MS,&nbsp;Kim L. Bennell PhD,&nbsp;Paul DeVita PhD","doi":"10.1002/acr.80017","DOIUrl":"10.1002/acr.80017","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We examined whether 18 months of strength training in individuals with knee varus alignment and medial tibiofemoral osteoarthritis (OA) reduced knee joint loads during walking compared to an attention control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was a secondary analysis of a randomized clinical trial that compared the effects of strength training to a control group in adults with knee OA. For this analysis, control participants had knee varus malalignment (≥2° varus; N = 49); participants in the strength training group met the varus malalignment criterion and increased their hip abductor strength by ≥20% from baseline to 18-month follow-up (N = 39). Linear regressions were used to compare means between groups at 18 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The strength training group had greater increases in strength in the quadriceps (45%), hamstrings (68%), and hip abductors (42%) than the control group (16%, 11%, 4%, respectively; <i>P</i> &lt; 0.05). There were no significant differences in the mean peak internal knee abduction moment or mean peak knee compressive force between groups at 18-month follow-up. The adjusted means at 18-month follow-up for the internal knee extension moment were significantly less (27%) in the strength training group (<i>P</i>_adjusted = 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among older adults with knee OA and varus alignment, long-term lower extremity strength training results in significant increases in strength but does not significantly alter most measures of knee joint loading during walking relative to an attention control group. The results cast doubt on whether clinically meaningful improvement in lower extremity muscle strength translates to clinically important attenuation in knee joint loading.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 9","pages":"1220-1228"},"PeriodicalIF":4.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.80017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146199946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}